Elderly in India – Current Scenario

We live in an aging world. India is a greying population as the mortality and fertility rates are on a decline. The elderly have been defined as those above the age of 60yrs. Old age has been categorized into young old (60- 69 yrs.),old old (70-79 yrs) and oldest old (>80yrs).

According to Population Census 2011 there are nearly 104 million persons aged 60 years or above in India, which is expected to grow to 173 million by year 2026. Elderly population was 5.6% in 1961 and has now increased to 8.6% in 2011. The life expectancy at birth during 2009-13 was 69.3 for females as against 65.8 years for males. Life expectancy in India was 31 years in 1947 which has risen to 69 years in 2015. Sharp decline in fertility rates combined with the socio economic growth in many developing countries will lead to a further increase in the population of the elderly in future.

With the changing lifestyle in modern society the young generation is migrating from rural to urban areas and from one country to another. The old - age dependency ratio climbed from 10.9% in 1961 to 14.2% in 2011 for India as a whole. Proportion of elderly females is slightly more than elderly males in India. As regards rural and urban areas, 71% of elderly population resides in rural areas while 29 % is in urban areas. In rural areas, 66% of elderly men and 28% of elderly women were working, while in urban areas only 46% of elderly men and about 11% of elderly women were working. In the age - group of 60 - 64 years, 76% persons were married while 22% were widowed. The increase in life expectancy with better health care, nutritious food and socioeconomic status along with decreased fertility rate has led to this demographic transition.

Prevalence of heart diseases among elderly population was much higher in urban areas than in rural parts.Most common disability among the aged persons was locomotor disability and visual disability as per Census 2011. Geriatrics is the branch of medicine that focuses on health care of the elderly. Geriatric medical care differs from usual medical care in shifting the focus to preservation of function and improving the quality of life rather than treating and curing specific diseases. Hence geriatric medicine focuses on restoration of function, on care rather than cure and on maintenance of independent living.

It has been observed that elderly frequently fail to utilize health care facilities. The reasons include poor health seeking behaviour, fear of exorbitant fees, traditional healers, spiritual house patronage and non-recognition of the possible significance of symptoms.

The incidence of chronic conditions like arthritis, hypertension, heart disease, hearing impairment, orthopaedic impairment, and cataract increases with increasing age which leads to increased functional impairments. Functional decline is more prevalent with age i.e., 20% of older persons over 65 years require assistance with Activities of Daily Living (ADL); 45% of older persons over 85 years require assistance with ADLs.

Government of India announced the National Policy on Older Persons in 1999 to reaffirm its commitment to ensure the well-being of the older persons in a holistic manner. The NPOP while promising to safeguard their interest in terms of financial security, health, legal, social and psychological security, also envisages a productive partnership with them in the process of development by creating opportunities for their gainful engagement and employment. The Policy also appreciates special needs of older persons and therefore lays emphasis on empowerment of community as well as individuals to adequately meet the challenges of the process of ageing. The Integrated Programme for Older Persons is a scheme that provides financial assistance up to 90 per cent of the project cost to non-governmental organizations or NGOs. Another program of the government is the Scheme of Assistance to Panchayat Raj Institutions voluntary organizations and self help groups for the construction of old age homes and multi service centres for older persons.

The Maintenance of Parents and Senior Citizens Bill of 2007 –provides for the maintenance of parents, establishment of old homes, provision of medical care and protection of life and property of senior citizens. The National Old Age Pension Scheme, Annapurna Scheme, Concessions/ Tax Rebate/Other Incentives and providing shelters for homeless elderly are few social security measures taken by government of India. Social security spending of Government also increases with the increase of old age population.

Ageing population has profound social, economic and political implications with increasing strain on health care and social care systems in the country. India needs more and more health and medical services, facilities and resources. Dependency increases as they grow older, due to their reduced mobility and debilitating disabilities. With increasing nuclear family, the care of olderpersons in the families gets increasingly difficult. To fulfil caring needs of aged persons more and more nursing people with appropriate skills are required.To face these challenges of ageing population, India needs to be prepared with appropriate social and economic policies. New priorities must be added tothe scarce resources for social programs for elderly, while still having to deal with the problems of the younger populations.

Let’s join hands to Add life to their years.